Background: At our quaternary academic medical center the process of dictating discharge summaries historically led to delays such that discharge summaries were being completed on average of more than 5 days after discharge. Our geriatricians in skilled nursing facilities only “rarely” or “sometimes” received discharge summaries from our hospital. The purpose of this study was [...]

Background: Computer provider order entny (CPOE) systems with clinical decision support can alert providers to medication ordering errors such as duplicate medication orders. Yet many ordering errors persist despite these interventions. Duplicate orders after CPOE implementation are analyzed to determine why these errors may persist despite decision support. Methods: CPOE was implemented in a 400‐bed [...]

Background: Length of stay in U.S. hospitals has been trending downward, and correlations to both outcomes and patient satisfaction are mixed. We compared measures of patient satisfaction with hospitalists' communication skills to average patient length of stay and readmission rates for individual hospitalists working on a short‐stay inpatient unit. Methods: Patient satisfaction with hospitalist communication [...]

Background: Community‐acquired pneumonia is a clinical diagnosis determined by the presence of respiratory signs and symptoms. Unfortunately, these clinical findings are not specific and may represent manifestations of other conditions. In addition, pneumonia may be caused by bacterial or viral pathogens. which leads to uncertainty about the appropriateness of antibiotic usage. Given this diagnostic uncertainly, [...]

Background: Over the past several decades, there has been a rapid influx ol new information lor diagnostic and therapeutic interventions. It is increasingly challenging for hospitalists to continue to integrate new knowledge while complying with existing standards of patient care. To create a high reliability system, health care requires a multidisciplinary approach with decision support [...]

Background: Proper coding is an essential skill necessary to capture the appropriate level of care provided by the physician. Both undercoding and overcoding are problematic, and few residency programs adequately educate trainees in this skill. A key coding difficurty is differentiating between level 2 and level 3 daily care charges. Although educational sessions are important [...]

Background: Contaminated blood cultures in the hospital setting are a potentially preventable cause of increased length of stay, unnecessary resource utilization, and unnecessary use of antibiotics. Estimates of the impact of contaminated blood cultures range from $1000 to $4385 and up to an additional 4.5 days of length of stay for each inpatient admission during [...]

Background: Interns, residents, and hospitalists conduct morning rounds in hospitals to determine the plan of care for the patients and to determine the learning needs of the house staff. At Virginia Mason Medical Center with the introduction of hospitalists, rounds predictably followed the time‐honored pattern of intern prerounds followed by hospitalisMed work rounds. Conceptually, morning [...]

Background: The delivery of safe and high‐quality patient care requires providers to learn from cases involving suboptimal events or outcomes. Although hospitai incident reporting systems generate triggers for case reviews, literature demonstrates insufficient representation of physician utilization of this system. Additionally, new regulatory pressures encourage physician‐led groups to examine their own performance and that of [...]

Background: Poor handoff communication poses a threat to patient safely. The medical literature to dale has focused on handoffs within a single facility or at hospital discharge. There are no assessments of the quality of handoffs for patients transferred from outside hospitals (OSHs). which is a common occurrence at academic medical centers. Purpose: To assess [...]